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Durable Medical Equipment

Durable Medical Equipment (DME) is equipment that withstands repeated use and is used primarily to serve a definite medical purpose. It is not generally useful to a person in the absence of an illness or injury. Click below to view:

What DME Does Medicaid Cover and does it need a PA?

Medicaid covers DME such as wheelchairs, hospital beds, orthotic appliances (foot/leg braces), prosthetic devices (artificial limbs) etc., and disposable medical equipment ordered by an accepted prescriber that is medically necessary and suitable for use in the home.

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Does DME Need to be Prior Authorized?

Some items require prior authorization by the supplier.

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DME Updates

DME UPDATE - For codes ‘E2359 to E2365’ for Batteries

Effective Jan. 1, 2013, procedure code has been changed from 'one' to 'two' every 24 months.

Important Information

A list of NDCs for the Diabetic supplies covered through the pharmacy program can be found on the Magellan Medicaid Administration web site. Please click on the Diabetic Supply Tab and then on the Diabetic Supply Preferred Product List. NDC numbers are required to bill diabetic supplies.

DME Updates

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Archives

2010 Durable Medical Equipment (DME) Fee Schedules

DME Fee Schedule, revision date Dec. 2010: PDF - Excel
DME Fee Schedule, revision date Nov. 3, 2010: PDF - Excel
DME Fee Schedule, revision date Oct. 5, 2010: PDF - Excel
DME Fee Schedule, revision date July 2010: PDF - Excel
DME Fee Schedule, revision date May 2010: PDF - Excel
DME Fee Schedule, revision date Jan. 2010: PDF - Excel

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2009 DME Fee Schedules

DME Fee Schedule, revision date Sept. 2009: PDF - Excel
DME Fee Schedule, revision date July 2009: PDF - Excel
DME Fee Schedule, revision date June 2009: PDF - Excel
DME Fee Schedule, revision date April 2009: PDF - Excel
DME Fee Schedule, revision date Feb. 2009: PDF - Excel
DME Fee Schedule, revision date Jan. 2009: PDF - Excel

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2008 DME Fee Schedules

DME Fee Schedule, revision date Dec. 2008: PDF - Excel
DME Fee Schedule, revision date Oct. 2008: PDF - Excel
DME Fee Schedule, revision date Sept. 2008: PDF - Excel
DME Fee Schedule, revision date Aug. 2008: PDF - Excel
DMS Fee Schedule, revision date July 2008: PDF - Excel
DME Fee Schedule, revision date June 2008: PDF - Excel
DME Fee Schedule, revision date May 2008: PDF - Excel
DME Fee Schedule, revision date April 2008: PDF - Excel
DME Fee Schedule, revision date Feb. 2008: PDF - Excel
DME Fee Schedule, revision date Jan. 2008: PDF - Excel

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2007 DME Fee Schedules

DME Fee Schedule, revision date Sept. 2007: PDF - Excel
DME Fee Schedule, revision date July 2007: PDF - Excel
DME Fee Schedule, revision date April 2007: Excel - PDF
DME Fee Schedule, revision date Feb. 2007: PDF - Excel

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2006 DME Fee Schedules

DME Fee Schedule as of Oct. 19, 2006: PDF
New K Code Reimbursements as of Dec. 15, 2006: PDF - Excel

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Regulations, Provider Letters, Forms, Billing Information and Fee Schedules
 

Regulations
907 KAR 1:479

Provider Letters

View other provider letters on the Provider Letter page.

Forms

  • Map-9 - Prior Authorization for Health Services and Instructions
  • MAP-1000 - Certificate of Medical Necessity -Durable Medical Equipment
  • MAP-1000B - Certificate of Medical Necessity - Metabolic Formulas and Foods
  • MAP-1001 - Advance Member Notice

Billing Information

Fee Schedule
View the most current Fee Schedule on the Fee and Rate Schedule page.

 

For questions
 

Regarding policy, contact
Division of Provider Operations
Physicians and Individual Providers Branch
275 East Main St.
6W-D
Frankfort, KY 40621
Phone: (502) 564-2687
Email:
CHFS DMS Webmaster

Regarding billing issues, contact (800) 807-1232

Regarding enrolling as a provider, refer to the provider enrollment website.

 

Last Updated 12/16/2013
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